The science of ‘Game of Thrones’ — how did Samwell get those gloves?

Samwell studying the White Walkers at the Citadel on 'Game of Thrones.'

By

KentSepkowitz

Kent Sepkowitz, MD, is an infectious disease specialist at Memorial Sloan Kettering Cancer Center. Here, Dr. Sepkowitz weighs in on this week’s season premiere of “Game of Thrones” and the unexpected appearance of a modern surgical procedure.

“Game of Thrones” season 7 started out with some favorite old tropes — a mass poisoning, some maybe-treachery, rabid megalomania — but introduced an odd new focus for consideration: rubber gloves.

The nebbish Sam Tarly, newly arrived at the fabulous Citadel, has discovered that his dream job has its limits, at least initially. Last season on Time Warner’s
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HBO, we watched him go gaga at his first glance at the library, all smiles and hope. But this season, we find him decidedly at the bottom rung of librarian life: He’s stuck wheeling a heavy wagon of books from here to there, to make reshelving a little easier.

He also seems to have been assigned to a hospital ward, a place where everyone seems to have diarrhea or vomiting — a pretty gross place. And here Sam’s task is lowlier yet — he’s the guy who has to empty and clean the chamber pots. Albeit with rubber-y looking gloves.

In an episode noticeably lacking in sex, nudity or even kissing, we are given a too-long bit on the sights and sounds of gastroenteritis. Hapless Sam, himself nauseous by having to deal with the facts of human illness, staggers a bit — though not so much that he loses his love of information or strays from his quest to learn how to stop the White Walkers.

The rubbery gloves appear in a second, equally unexpected place: At the autopsy table. Last season also opened with a dead man on the slab — Jon Snow spent a while there before his re-animation. But this go-around is a standard issue dissection where we find Sam working as first assistant, tasked with the weighing of eviscerated organs. And wearing the same rubbery looking gloves. Yes, in both the cleaning of pots and the grabbing of hearts, Sam is protected.

It’s an unexpected embrace of hand hygiene, previously not much appreciated on the “Game of Thrones.” We have seen all manner of blood and guts and, other than wiping a sword clean (the better to stab you with), very little concern about maintenance of sterile techniques.

As an aside, the story of when and why real rubber gloves entered the medical world is well established: it relates not to cleanliness but rather to the delicate skin of an operating-room nurse working with the great American surgeon — and eventual cocaine and morphine addict — William Halsted.

Halsted worked in the last part of the 19th century when antisepsis — the sterilizing chemicals used to clean and dress wounds — was all the rage. However, it proved too harsh for the nurse’s hands. So Halsted had his buddies at Goodyear Rubber Co.
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design a set of rubber gloves to protect her hands from severe chemical irritation. The benefits of the gloves for sterility quickly became evident and an operating-room standard was born.

In Westeros, the story of healthcare gloves or contact isolation to prevent disease transmission isn’t known. The presence of the gloves — good ones too, they run halfway up the elbow — in a mostly medieval time (not counting the occasional skyscraper) is another of the many weird temporal misplacements and lapses of verisimilitude on “Game of Thrones” that seem to be for fun, forgettable little who-knows and who-cares moments.

So too it seemed with the gloves — until the end of the episode, when the entire theme of hygiene and contagion suggests itself as a Big Deal for the season. As Sam is glumly collecting chamber pots a second time, now from patients locked behind wooden walls for isolation, a patient’s hand unexpectedly thrusts through a small opening. The camera lingers and we realize that the mysterious arm is afflicted with greyscale, the most alarming, contagious disease in Westeros. Furthermore, it becomes clear that the afflicted patient is Jorah Mormont, the only featured player with the disease since the, um, untimely death of young Shireen Baratheon.

As America debates the future of healthcare, perhaps the denizens of Westeros will spend much of Season 7 thinking about health maintenance and delivery, even max lifetime deductibles, as infection, prevention, and remedy become the talk of the seven kingdoms.

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